Phase 3 Mod 2 Deck 1 Flashcards
1
Q
_________ is a medical reason not to give a medication.
A
Contraindication
2
Q
__________ is the movement of the limbs toward the medial plane of the body or the axial line of a limb.
A
Adduction
adding to the body
3
Q
_________ is the level of a medication in the blood in which tissue damage is likely.
A
Toxic level
4
Q
What is the maximum recommended daily dose of acetaminophen?
A
3g
3,000 mg
5
Q
What is penicillinase?
A
An enzyme produced by penicillin resistant bacterium which blocks penicillin inside the bacterium.
6
Q
What is the approximate dose of toxicity associated with a single dose of acetaminophen ingestion?
A
Approximately 7 - 10 grams
150 mg/kg
7
Q
How many points should NSAIDs be expected to lower pain on the 0-10 pain scale?
A
Lowered by 1-2 points
Ex. If pain was a 7, NSAIDs should lower pain to 5
8
Q
__________ is an inflammation of the tendons that join the forearm muscles on the inner and outer aspects of the elbow.
A
Epicondylitis
***The elbow joint is made up of the humerus and ulna. The bony prominences at the distal portion of the humerus are called the epicondyles.
9
Q
What is the most common cause of shoulder dislocations?
A
Falling
10
Q
_________ are broad spectrum antibiotics that are effective against both gram-positive and gram-negative bacterium.
A
Macrolides
11
Q
Which classification of medications is commonly utilized for patients suffering from acute asthmatic exacerbations?
A
Corticosteroids
12
Q
What is diffusion?
A
The flow of gas or liquid from an area of higher concentration to an area of lesser concentration.
13
Q
What are the two types of cyclo-oxygenase (COX)?
A
COX 1 - involved in the formation of prostaglandins that maintain the integrity of the gastrointestinal mucosa.
COX 2 - is made primarily in response to injury or inflammation and is involved in the formation of prostaglandins which cause inflammation.
14
Q
_________ is the variable levels of a medication within the blood, between the therapeutic level and the toxic level.
A
Therapeutic range
Some medications have a “narrow” therapeutic range and require very close monitoring
15
Q
What is the approximate half-life of Narcan?
A
0.5 - 1.5 hours
30 - 90 minutes
16
Q
After a rapid ascent, your patient develops signs of dyspnea while at rest, cyanosis, rales, and tachypnea. What form of altitude sickness should you suspect?
A
HAPE - High Altitude Pulmonary Edema
17
Q
Their are three anatomical planes of the human body. What are they?
A
- Sagittal (vertical): equal left and right halves
- Coronal (frontal): front and back plane
- Axial (transverse): upper and lower (midline; waist)
18
Q
What classification of medications are commonly prescribed for acute back pain and/or spasms?
A
Muscle relaxers
- Methocarbamol (Robaxin)
- Cyclobenzaprine (Flexeril)
19
Q
Why are different bacterias determined to be either gram-positive or gram-negative?
A
Different classes of bacteria require different antibiotics or different dosing because of their own metabolism.
20
Q
_________ is the study of substances that interact with living organisms through chemical processes.
A
Pharmacology
21
Q
What is the approximate half-life of morphine sulfate?
A
2 - 3 hours
120 - 180 minutes
22
Q
What is the approximate half-life of ketamine?
A
2.5 hours
150 minutes
23
Q
What is a gradient?
A
The difference in pressures from the high concentration to the lower concentration.
24
Q
How many generations of cephalosporins are there?
A
Four:
- 1st: gram-positive bacterium (cefazolin, cephalexin)
- 2nd: gram-positive bacterium (cefuroxime)
- 3rd: gram-positive/negative bacterium (Rocephin)
- 4th: gram-positive/negative bacterium (cefipme)
25
Which anatomical plane separates the body into superior and inferior portions?
Axial (transverse)
***upper and lower (midline; waist)***
26
What is tendon attrition?
Weakening of the tendons
***could be caused by bone spurs rubbing together***
27
Which anatomical plane separates the body into anterior and posterior portions?
Coronal (frontal)
***front and back plane***
28
Topical corticosteroids are categorized in groups by strength from 1 - 7. Which end of the spectrum is the strongest? Which end of the spectrum is the weakest?
1 is the strongest (prescription); 7 is the weakest (OTC)
29
How does penicillin work?
Inhibiting cell wall production of peptidoglycan
***against gram-positive, aerobic organisms***
30
__________ is a cerebral and/or pulmonary syndrome(s) that can develop in unacclimatized persons shortly after ascent to high altitude.
High Altitude Illness
31
_________ is when a medication is at its highest concentration (maximum benefit).
Peak
32
Which analgesic medication is known to potentially cause severe hypotension in an individual whose ability to maintain blood pressure has already been compromised by depleted blood volume?
Morphine
***Morphine may produce orthostatic hypotension and syncope in ambulatory patients***
33
_________ is the time until the medication's therapeutic effect wears off.
Duration of therapy
34
_________ the reasons or conditions for which a particular medication is given.
Indication
35
How many bones are their in the wrist?
Eight
36
What is the recommended adult dose of Tramadol (Ultram)?
50 - 100 mg q 4-6 hours
| ***maximum dose: 400 mg/daily***
37
__________ is the difference in pressures from the high concentration to the lower concentration.
Gradient
38
What is the best way to speed up acclimatization?
There isn't one
39
Antibiotics:
What type of bacteria is penicillin effective against?
Gram-positive, aerobic organisms
40
__________ is the act of turning the palm posteriorly (backward) or inferiorly (downward) by medially rotating the forearm.
Pronation
***laying prone***
41
At low adult doses, which medication relieves pain twice as well as morphine?
Ketamine
42
_________ is the lowest level of medication in the blood in between dosages.
Trough
43
How long does the treatment for HAPE last while in a Gamow bag?
HAPE - High Altitude Pulmonary Edema:
Approximately 4 hours
44
_________ is the amount of medication given at or within a specified period of time.
Dose
45
__________ is acute swelling of the brain due to rapid ascent in altitude.
High Altitude Cerebral Edema (HACE)
46
Why don't antibiotics work on fungi?
Antibiotics work by disrupting the chemical processes of bacteria and inhibit reproduction. Fungi however can reproduce either sexually or asexually.
47
_________ is the time until a medication's therapeutic effect wears off.
Onset
48
_________ is the amount of medication per form of delivery (tablet, capsule, etc.).
Strength
* **Gm, Mg, Mcg - solids***
* ** mL - fluids***
49
Which type of shoulder dislocation (direction wise) is the most common treated?
Anterior dislocations (98%)
50
_________ is a relative constant blood level of medication which is sustained after 5-6 half-lives of medication.
Steady state
51
__________ have a slower onset and longer duration, having been compounded with inhaled steroids for long-term control of asthma.
Long Acting Beta Agonists (LABA)
52
__________ requires people to ascend (rise) to a moderate altitude and remain there for 3 days or more to acclimatize before ascending higher.
Staged Ascent
***When possible, Soldiers should make several stops for staging during the ascent to allow a greater degree of acclimatization.
53
What is a common symptom of a patient suffering from HACE?
High Altitude Cerebral Edema: Ataxia (lack of coordination)
*** to include altered mental status with headache, fatigue, nausea and/or vomiting***
54
__________ includes any type of irritation or damage to your rotator cuff muscles or tendons.
Rotator cuff injuries
55
When do symptoms of Acute Mountain Sickness (AMS) usually develop?
6-10 hours after ascent
56
_________ - all of the limitations, considerations and instructions required, regarding a medication, to help achieve the desired physiological response while minimizing side effects.
Dosing parameters
57
What is the primary organ that metabolizes acetaminophen?
Liver
58
__________ is the movement of the forearm in which the palm faces up anteriorly.
Supination
***holding a cup of soup***
59
What is the antidote for acute acetaminophen toxicity?
N-Acetylcysteine
***Mucomyst***
60
__________ limits the daily altitude gain to allow partial acclimatization.
Example: Begin at 9,000 ft and limit the sleeping altitude to no more than 1,000 ft per day above the previous night's sleeping altitude.
Graded Ascent
***The altitude at which Soldier's sleep is the critical element in this regard***
61
__________ is a partial or incomplete dislocation.
Subluxation
62
How is medial epicondylitis pain reproduced?
With flexion and pronation
63
__________ is the movement of the limbs toward the lateral plane or away the axial line of a limb.
Abduction
***abducted from the body***
64
How long does the treatment for Acute Mountain Sickness last while in a Gamow bag?
Approximately 2 hours
65
What is the primary organ injured subsequent to acetaminophen overdose?
Liver
66
_________ occurs when infectious organisms adapt to antibiotics or antivirals and it takes either higher doses of the same medication or a change to different medication to kill the organism.
Resistance
67
_________ is the process of the body breaking down and eliminating medications.
Metabolism
***most medications are metabolized by the liver or kidneys***
68
__________ is a displacement of a bone from a joint.
Dislocation
69
What is the average dosage range that morphine is titrated between?
5 - 20 mg
70
What is the likely effectiveness of an antibiotic on a virus or fungus?
Ineffective
71
__________ is inadequate oxygen content in the blood.
Hypoxia (also called hypoxemia)
72
_________ is an immune response in which there is a hypersensitivity response induced by exposure to a particular medication, which could be life threatening in certain circumstances.
Allergy
73
What is a common side effect of pseudoephedrine that medics should be cognizant of?
Potential to elevate blood pressure
74
The term eustachian refers to the __________.
Ears
75
_________ occurs when medication is administered in variable strength, interval, and quantity to achieve and maintain a desired, observable physiological effect.
Titration (titrate to effect)
76
__________ are portable pressure chambers used to treat casualties with high altitude sickness disorders.
Gamow bag(s)
77
What does "comorbidities" refer to?
Other medical problems, besides the reason the current medication is being administered, which may affect metabolism or may make the patient more susceptible for a side effect or toxicity.
78
__________ rapidly open the bronchi and are useful in acute cases such as asthma attacks in asthmatics..
Short Acting Beta Agonists (SABA)
79
__________ is acute accumulation of fluid in the alveoli due to rapid ascent in altitude.
High Altitude Pulmonary Edema (HAPE)
80
How long does the treatment for HACE last while in a Gamow bag?
HACE - High Altitude Cerebral Edema
Approximately 6 hours
81
What is pharmacology?
Pharmacology is the study of substances that interact with living organisms through chemical processes.
82
What are the three main factors that affect medication dosages?
1. Body weight
2. Comorbidities
3. Age
83
_________ is an unintended, but not-surprising consequence of a medication (besides an allergy) which may require a medication dose be changed or discontinued.
Side effect
84
__________ is the painful inflammation of the tendons on the inner aspect of the elbow.
Medial epicondylitis (golfer's elbow)
***aka wrist flexor tendonitis or elbow tendonitis***
85
_________ is the science of substances used to prevent, diagnose, and treat diseases.
Medical pharmacology
86
_________ occurs when the body has adapted to having a medication regularly and now requires higher or more frequent doses to achieve the therapeutic effect.
Tolerance
87
At high doses, which medication dissociates conscious thought from sensory input, including pain (Patient just doesn't care).
Ketamine
88
What are the two categories of contraindications?
1. Absolute - medical reason to NEVER give medication
| 2. Relative - medical reason a medication should not be given, but may be acceptable in certain circumstances.
89
Why should the use of oxymetazoline (Afrin) be limited to 3 days or less?
Use greater then 3 days may result in rhinitis medicamentosa, where the nasal membranes are dependent on the medication.
90
What gland produces cortisol, which is an anti-inflammatory steroid?
Adrenal gland
91
What is the most effective way to prevent high altitude illnesses and achieve maximum acclimatization?
Combine the staged ascent and graded ascent
92
Gram _________ indicates that the cell membrane outer structure consists of a cytoplasmic membrane surrounded by a thin layer of peptidoglycan.
Gram-negative
***due to the thin layer of peptidoglycan, the bacterium does NOT retain the color of the gram staining***
93
_________ is the range of acceptable DOSAGES of a medication needed to keep blood levels within the therapeutic range.
Therapeutic window
***Some medications have a "narrow" therapeutic window and require very close monitoring***
94
__________ is the process whereby the body gradually adapts to the climate and environment.
Acclimatization
95
_________ is the blood level of a medication required to achieve the therapeutic effect.
Therapeutic level
96
Which class of antibiotics are know to stimulate motilin receptors in the gastrointestinal tract and cause diarrhea?
Macrolides
97
What medication can be used to help patients suffering from some degree of altitude sickness (AMS, HAPE, HACE)?
Diamox (acetazolamide) 250 mg PO q 8-12 hrs
98
What are the two methods for achieving acclimatization?
1. Staged Ascent
| 2. Graded Ascent
99
_________ is a substance that forms a tough, rigid structure of the bacterium wall.
Peptidoglycan
* **indicates gram-positive bacteria***
* **due to the thick layer of peptidoglycan, the bacterium retains the color of the gram staining***
100
What medication is used as an opioid antagonist?
Narcan (naloxone)
101
What are the TWO main key concerns (side effects) when administering morphine sulfate?
1. Respiratory depression
| 2. Hypotension
102
What is the primary cause of death subsequent to toxic acetaminophen ingestion?
Liver failure (usually within 1 week)
103
What are the two categories that gram-stain testing places bacteria in?
1. Gram-postive
| 2. Gram-negative
104
__________ is a syndrome due to rapid ascent in altitude consisting of headache, nausea, vomiting, and fatigue.
Acute Mountain Sickness (AMS)
105
What is Methocarbamol (Robaxin) and Cyclobenzaprine (Flexeril) primarily prescribed for?
Acute back pain and/or spasms
106
What do corticosteroids simulate?
Cortisol, which is an anti-inflammatory steroid produced in the adrenal gland.
107
_________ is the time it takes for the body to eliminate 1/2 of the medication dose.
Half-life
***Ex: Benadryl has a half-life of nine hours. If a PT takes 50 mg at 21:00, then nine hours later (06:00), the PT still has 25 mg in his/her system. Nine hours after that (15:00), the PT has 12.5 mg in his/her system.
108
What is the standard dose for Narcan?
0.4 - 2.0 mg IV, IO, ET (x2 dose)
109
Why is it recommended that patients rinse their mouth after using a corticosteroid inhaler?
To reduce the risk of oral candidiasis (thrush)
110
_________ is the recommended time period between doses of a medication.
Dosing interval
111
Meloxicam (Mobic) is an example of which type of NSAID?
Cyclo-oxygenase 2
| COX-2
112
__________ is movement that decreases the angle between two articulating bones, bending the limb.
Flexion
113
Other medical problems, besides the reason the current medication is being administered, which may affect metabolism or may make the patient more susceptible for a side effect or toxicity is defined as:
Comorbidities
114
The management of which form of high altitude sickness includes the use of Dexamethasone (4 mg PO, IM or IV q 6 hrs) and/or Nifedipine 'Procardia' (10 mg gel caps)
HAPE - High Altitude Pulmonary Edema
115
Which NSAID is prohibited in combat theaters except in cases of medical necessity?
Aspirin (ASA)
***due to concern of worse hemorrhaging due to its affects on platelet formation***
116
__________ is a fluid-filled cavity near joints, where tendons or muscles pass over bony projections.
Bursitis (bursea)
117
__________ is a localized or generalized excessive amount of tissue fluid (swelling).
Edema
118
Which medications are intended to kill or inhibit the reproduction of bacteria?
Antibiotics
119
__________ is movement that increases the angle between two adjoining bones.
Extension
120
Gram _________ indicates the presence of peptidoglycan.
Gram-positive
121
__________ is the painful inflammation of the tendons on the outer aspect of the elbow.
Lateral epicondylitis (tennis elbow)
***aka wrist extensor tendonitis or elbow tendonitis***
122
Which analgesic medication is chemically related to phencyclidine (aka PCP or Angel Dust) but has very potent analgesic and dissociative effects?
Ketamine
123
__________ is the pressure of one particular gas in a gas mixture (such as the pressure of just oxygen mixed in the atmosphere).
Partial Pressure
124
Which classification of medications block cyclo-oxygenase?
NSIADs
125
_________ is involved in the formation of prostaglandins that maintain the integrity of the gastrointestinal mucosa.
Cyclo-oxygenase 1
(COX-1)
***Non-selective NSAIDs***
126
Which anatomical plane separates the body into left and right sides?
Sagittal (vertical)
127
What is a positive Sulcus sign? What type of injury does it suggest?
Sulcus sign is suggestive of a shoulder dislocation due to a pocket (or void) where the shoulder joint should be (if positive).
***the pocket is caused by negative pressure***
128
_________ is the desired change in physiology for administering the medication.
Therapeutic effect
129
Erythromycin and azithromycin are examples of which antibiotic?
Macrolides
130
What are the three categories of patient dosages?
1. Single dose - amount of medication administered at one time.
2. Maximum dose - the largest amount of medication either as a single dose or within a period of time such as 24 hours.
3. Cumulative dose - the sum of all single doses over either a lifetime or a period of time.
131
How doe NSAIDs work?
NSAIDs block cyclo-oxygenase (COX)
132
__________ is the largest carpal bone in the wrist and the most likely to fracture.
Scaphoid
***FOOSH (Fall On Outstretched Hand) injuries***
